Maternal obesity and the human milk metabolome: associations with infant body composition and postnatal weight gain

Abstract

BackgroundMaternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear.ObjectivesWe aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain.MethodsThis was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery (n = 35 mother–infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI <25 (lean) or ≥25 kg/m2 (overweight/obese). We analyzed infant body composition by dual-energy X-ray absorptiometry and used untargeted liquid chromatography–gas chromatography–mass spectrometry to measure the milk content of 275 metabolites at 1 and 6 mo postpartum.ResultsAt 1 mo postpartum, 10 metabolites differed between overweight/obese and lean groups with nominal P < 0.05, but none was altered with a false discovery rate <0.25. Many differentially abundant metabolites belonged to the same chemical class; e.g., 4/10 metabolites were nucleotide derivatives, and 3/10 were human milk oligosaccharides. Milk adenine correlated positively with both continuously distributed maternal BMI and with infant adiposity and fat accrual. Analysis of milk composition at 6 mo postpartum revealed 20 differentially abundant metabolites (P < 0.05) in overweight/obese compared with lean women, including 6 metabolites with a false discovery rate of <0.25. At both 1 and 6 mo, human milk abundance of 1,5-anhydroglucitol, which has not previously been described in milk, was positively associated with maternal BMI.ConclusionsMaternal obesity is associated with changes in the human milk metabolome. While only a subset of metabolites correlated with both maternal and infant weight, these point to potential milk-dependent mechanisms for mother–child transmission of obesity. This trial was registered at www.clinicaltrials.gov as NCT02535637.

Human milk oligosaccharide 2’-fucosyllactose links feedings at 1 month to cognitive development at 24 months in infants of normal and overweight mothers

“…As we postulated in a previous publication in the same cohort [19], maternal obesity may persist after pregnancy, and alter breast milk characteristics [8,9,19,34]: this includes neuroactive components for infant cognitive development [9,34]. However, we found that maternal obesity before pregnancy was a separate influence, unrelated to breast milk factors.…”

Early‐Life Gut Microbiome—The Importance of Maternal and Infant Factors in Its Establishment

“…Maternal weight status also might affect maternal milk composition 131,132 . Recent data associating the milk metabolome with both maternal and infant obesity suggest that obesity‐related differences in human milk composition might contribute to early childhood obesity 133 . Cabrera‐Rubio et al detected higher total bacterial counts, expansion of Staphylococcus and Lactobacillus , and reduced levels of Bifidobacterium in the milk of obese compared with normal‐weight women during the first 6 months of lactation 88 .…”

Human Milk From Atopic Mothers Has Lower Levels of Short Chain Fatty Acids

“…While genetics and epigenetics play a role in the inheritance of atopic disease (3,4), the role of HM metabolites remains underexplored in this field. Still in its infancy, the study of the HM metabolome has proven valuable in identifying variability by maternal phenotype, diet, and disease state (5,6). Short chain fatty acids (SCFAs) are key metabolites of microbial fermentation of fiber that have links with host health.…”